Individual
DR. JAMES LEE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 S PROSPECT ST, BURLINGTON, VT 05401-3456
(802) 847-4560
(802) 847-8747
Mailing address
99 SUTTON FARM DR, WILLISTON, VT 05495-9606
(802) 878-2329
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0420010031
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02087332
—
NY
05
—
0VN2314
—
VT
Enumeration date
07/20/2006
Last updated
07/08/2007
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